C型肝炎

■どんな病気なのか

◎血液の感染が大半
C型肝炎ウイルス(HCV)の感染が原因で起こる肝炎の事を《C型肝炎》という。
日本のC型肝炎ウイルス感染者数は150万人~250万人と言われている。
ウイルスを持っているにも関わらず、肝臓の障害に気がついていない方は約60万人いると推定されている。

◎性行為による感染率というのは低いです。
C型肝炎ウイルスは血液によって感染する。
性行為によって感染する可能性がありますが、感染する確率は低い。

◎慢性化する事が多い
C型肝炎は症状が軽い。感染者の7割前後は慢性化する。
肝硬変から肝臓がんに進む可能性が高いですので、注意が必要となります。
肝臓がんによって死亡者数は年間3万人を超え増加傾向がある。その8割がC型肝炎を伴っている。

■どうしてうつってしまうのか
性行為による感染の可能性は低い
◎妊婦の方は妊婦検診を受ける事によって、出産時の母子感染を防ぐ事が出来ます。
◎性行為による感染というのはまれですが、アナルセックスや生理中などに行う性行為は出血と粘膜の損傷を伴う性行為は感染の危険性は高いと考えられています。
◎輸血による感染というのは献血された血液を検査する事によって現在ではほぼ起きていない。
◎安全ではない血液製剤により薬害としてC型肝炎ウイルスに感染した人もいる。

■どんな症状
①性行為などによって感染した日
※男女共に同じような症状が出る

②潜伏期間
感染直後から2週間~3ヶ月位
※個人差がある。症状が出るまでに約2週間~3ヶ月掛かる。
C型肝炎ウイルスの抗体が出来るまで期間は約1~3ヶ月とされている。

③症状が出る
主な症状
食欲がない、全身倦怠(だるさ)濃い色の尿が出る。発熱、黄疸(体や白目が黄色っぽくなる)など
急性C型肝炎でこのような症状が出る人は20~30%と言われている。
一般的にA型肝炎やB型肝炎に比べて症状は軽い。
自覚症状の現れない人もいる。

④症状が治まる
治療を行って、慢性化、劇症化(肝臓の炎症が高くなり、肝細胞の殆どが死ぬ)しなければ治る。
またC型肝炎の特徴は慢性化する事によって初感染例の
約62~77%が慢性化すると考えられる。

■検査について
臨床診断と血液検査を行う

症状が出るまでと検査のタイミング

①性行為などによって感染した日
2週間~3ヶ月
症状が出ていない状態でもパートナーに感染させてしまう事ある。(70~80%の人は出ない)
※検査は出来ない。
検査可能日は検査方法によって異なる。感染日から一週間後~3ヶ月後

②症状が出る
※検査が出来ます。

■病院を受診する場合

◎受診科
男女共に内科(消化器科)

◎治療費用
診察料→3.000~5.000円
検査代→3.500円
薬代 →別途料金掛かる
※保険的用でない場合のおおよその金額です。保険適用の場合、3割負担となります。

■治療について

C型肝炎の治療
その状態によって方法、そして効果が違ってきますので、医師の判断によって行われます。
※急性肝炎の場合→抗炎症療法、食事療法、安静など
※慢性肝炎の場合→抗ウイルス剤の投与など

①感染していると医師に診断された

②個々の状態に合わせて治療法を決定
抗炎症療法、食事療法、安静、そして抗ウイルス剤の投与(リバビリン、インターフェロンなど)

③肝機能の正常化
検査数値が低下しているかを確認しながら診察を続けていきます。

治療を行って、慢性化劇症化(肝臓の炎症が非常に強くなって、肝細胞の殆どが死ぬ)しなければ治る。
また、C型肝炎の特徴は慢性化する事によって、慢性化した場合は自然と治る事は殆どなく、肝硬変から肝臓がんへの進行に注意が必要となる。

■どんな予防法があるのか
◎コンドーム
性行為により感染するのまれです。ただし、アナルセックス、生理中の性行為などと出血、粘膜の損傷を伴う性行為というのは感染の危険性が非常に高いと考えられる。性交時にコンドームを使用する事は有効。

◎パートナーの検査は必要か
C型肝炎ウイルス持続感染者(キャリア)のパートナーは念の為に検査を受けた方が望ましいでしょう。

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